"Racism is a socially transmitted disease, and we as health communicators can't be bystanders"
It’s said that the biggest problem in communication is that we do not listen to understand – we listen to reply. Too often in conversation, we’re already planning our responses while the other side’s still talking. We’re listening, but we’re not really listening – so how can we truly understand? Well, if ever there was a time for society to listen and learn, it’s now.
Our world is embroiled in parallel pandemics that are significantly damaging global health. Communications has a major role to play in the fight against both Covid-19 and systemic racism in healthcare. But we will only cut through to better outcomes in health and equality if we properly hear voices from diverse populations throughout (and beyond) the creative process.
The impact of institutional racism on health has been brutally exposed by Covid-19. Coronavirus has had a disproportionate effect on mortality rates in Black communities and a report from Public Health England cites discrimination as a root cause. The pandemic, it says, is ‘exacerbating existing inequalities’, with economic hardship, poor experiences of healthcare at work, coupled with historic racism making all BAME communities less likely to seek care when they needed it - increasing their risk of dying from Covid-19.
Health inequalities persisted long before Covid. Research reveals growing links between racism, morbidity and mortality. It shows racism negatively influences healthcare access, leading to poorer health and poorer survival rates in marginalized groups. Victims of discrimination are more likely to have respiratory illness, hypertension anxiety and depression. To add to this, stress from discrimination affects psychological health and immune systems. And it indicates discrimination sets children up for disease even before they're born.
The evidence is stark: minority groups are at a greater risk of chronic conditions. Black communities have higher incidence of heart disease, stroke and diabetes – and they’re more likely to die from asthma. There is racial disparity associated with later-stage diagnosis and lower survival rates for breast and lung cancers in black populations. In the UK, Black women are five times more likely to die from complications surrounding pregnancy and childbirth than white women, while in the US, infant mortality rates are consistently higher in black communities. The list goes on – and it makes uncomfortable reading.
As a society, we think we understand this – but we’re clearly not listening. There’s no adequate biological explanation for these persistent differences between racial groups and data has been published for many years citing that persistent stress, as a result of environmental factors like endemic racism, leads to chronic disease such as diabetes. But still, no one is listening, and things have not changed.
Racism is a socially transmitted disease, and we, as heath communicators can’t be bystanders. We need to take action to make things better. We have a responsibility to shine a light on injustice, shine a light on the facts and mobilise diverse voices to co-create communications that promote better health for all.
According to a 2018 UK study, all Black, Asian and Minority communities are better represented in advertising campaigns than at any time in history, but we must ensure diversity is represented within every single step of the creative and healthcare delivery process. It’s only by understanding reflecting diverse populations that we can develop communications that speak to – and support – every one of these health challenges. But we need to do more of it in practice.
Earlier this year (pre-pandemic) the Marmot Review revealed a widening of health inequalities in England since 2010. The UK’s Patients Association said the report highlighted ‘clear divides along economic, geographic and ethnic lines’, with those on the wrong sides of the divides unjustly living shorter lives.
The problem isn’t unique to Britain, it’s a worldwide pandemic laid bare by Covid-19. Marmot’s recommendations, praised by the Patients Association, centre around education, public engagement and system-wide partnerships to uncover and address the social determinants of health inequalities. Communications will be pivotal at every stage, with diverse and meaningful collaboration essential if we’re going to speak truth and drive change.
This is a global challenge. But if we’re truly inclusive – and listen intently so we really understand – we can together build critical pathways to better, fairer healthcare.
This piece was first published in The Drum